10-103753 IP liiilding - Single Family
City of Federal Way
Community Development Services Permit #: 10-103753-00-SF
P.O.Box 9718
Federal Way,WA 98063-9718 Insection Request Line: (253)83
Ph:(253)835-2607 Fax (253)835-2609 FILE
p Q5-3050
Project Name: FREDRICKSON
Project Address: 34218 28TH AVE SW Parcel Number: 294450 0300
Project Description: REP-Remove shake roof; install OSB decking: install comp shingles
,
caner Applicant Contractor Lender
ORVILLE&PHYLLIS MOSS MASTERS ROOFING LLC MOSS MASTERS ROOFING LLC
FREDRICKSON 12626 RENTON AVE S MOSSMMR9110W(9/16/11)
34218 28TH AVE SW SEATTLE WA 98178 12626 RENTON AVE S
FEDERAL WAY WA 98023-7610 SEATTLE WA 98178
,
Census Category: 328 -New Other Non-Residential Building
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
New/Additional Sq.Feet-.l st Floor 0 New/Additional Sq.Feet-2nd Floor......♦. ..,.....0
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0
Basic Plan" No New/Additional Sq.Feet-Deck 0
New/Additional Sq.Feet-Garage 0 Mechanical to be Included" No
New/Additional Sq.Feet-Other 0 Plumbing to be Included" No
New/Additional Sq.Feet-Total 0
p"� Shy yd/ ■<■ _ :.a� 1 t I! 4 1.
ttei;k
PERMIT EXPIRES Monday, February 28, 2011
Permit Issued on Wednesday, September 1, 2010
I hereby certify that the above i sr ,ation is correct and that the construction on the above described property and
the occupancy and the use w . in accordance with the laws, rules and regulations of the State of Washington
and the ity of Federal Way. J
Owner or agent: Date: f!"---/4--- /
kt 44/4'//0
THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction NSPECTEQUESTS t2�8Record
PERMIT#: 10-103753-00-SF Address: 34218 28TH AVE SW
Owner: ORVILLE & PHYLLIS FREDRICKS( FEDERAL WAY, WA 98023-7610
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
El SWM Precon Site Mtg(4400) 0 Initial Erosion Control(4365) ❑ Underfloor Framing(4285)
Approved To be done prior to breaking ground Approved to sheath floor
By Date By Date By Date
O Floor Sheathing(4105) CI Shear Walls (4245) `0 Roof Sheathing(4220)
Approved to install flooring Approved to install siding Approved to install roofing
By Date By Date By O " Date /*,0
O Fire/Draft Stops(4095) El Interim Erosion Control(4370)
Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in and
Fire/Draft Stop inspections must be signed-off and
By Date By Date approved. IBC 109.3.4
O Framing(4120) * 0 Insulation (4150) El Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By Date By Date
El Final Erosion Control(4375) El Final-Building(4050)
Approved Approved
By Date By i--- Date
0 Rough ElectricalEl Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
. _i ?„7 / 6 - tiO .3 _75-,S
"�'".::'.%:':.:>;:`::�, I CE F ,MIT f), MF CO ME PL DE EN FP
Federal Way
COIVIMLNITYDEVELOPMENT SERVICES SEP D� CATION
253-835-2607•FAX 25.3-835-2609
UP FZIN
SITE ADDRESS RAL ,1 I SUITE/UNIT#
g# ;;-2_,--riv--- i • e s
1
P VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ fie- --- - — —
- -
TYPE OF PERMIT a BUILD 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT i--� , i ' 5k
)�
(Tenant Name/Homeowner Last Name) t' U
PROJECT DESCRIPTION /►
Detailed description of work to jT�/" i"/el 6-1.— OS` i -'--" -t---%#'05'
be included on this permit only ---1--.1N)S ri—apQairi t-3 P-IV- -
NAME �'' ( PRIMARY PHONE /- j
PROPERTY OWNER /'1 /ALJ--5 1' it-C,02 �- •t.',^' OZ53' (a(®l �?;
MAILINGLADDRESS E-MAIL
Y.2/7 4, e— J U.
C STATE ZIP
4,211 A2 G" YZ3 .
NAME
t oS S' v1-1/5.-5-'/' %-� 5 cro v
A P,c PHONE
y 3f�-1
MAILING ADDRESS ff E-MAIL
CONTRACTOR ( ?6 2 t 1(2,- --,.....7-6,,,) /4��'5-
CITY STATE ZIP FAX
WA
CONTRACTOR'S t� �� ���� /���� ON � FEDERAL WAY BUSINESS LICENSE#
/''l7 ss
NAME PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME
PHO �
(The individual to receive and (/ i'y`J ''.-4; _.,' ` 5/1-/.'�
respond to all correspondence MAILING ADDRESS I E-MAIL
concerning this application)
CITY STATE ZIP. FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
♦ �� Q OWNER-FINANCED
Required value of$5,000 or more / -
(RCW 19.27.095)- MAILING ADDRESS,CITY,STATE,ZIP PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense f such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim es out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to t ity as a part of this a plication. ` j
SIGNATURE: 7 DATE ��/ !
PRINT NAME:
Bulletin#100—April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
• • •
•
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided) -
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial).
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST •
DUCTING GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Handsinlm) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS . URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS Iscitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES' :: :...y'F:4. :: :.• '':::::::::
CRITICAL AREAS ON PROPERTY. WATER PURVEYOR SEWER PURVEYOR VALUE OF.EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No ❑ Yes ❑ No
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
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FIRST FLOOR(or Mobile Home)
COVERED ENTRY
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Area Totals
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ESTIMATED SELLING PRICE$ 1 #OF BEDROOMS
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Area Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
in Square Feet Type Stories
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AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
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Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application